Биологические науки/ 11.Биоинженерия и биоинформатика

Ph.D. Porvan A.P., Tchepayou Olivier

Kharkiv National University of Radio Electronics

Application of Telemedicine Technology in the Diagnostic of Cardiovascular Desease

Nowadays cardiovascular diseases are more recurrent, and the World Health Organization (WHO) classifies them as the leading cause of death worldwide; with over 17.1million people affected each year. The proliferation of these diseases is due to the deterioration of the global economy, the consumption of tobacco and excessive alcohol, stress, and many others. These diseases such as coronary heart disease and high blood pressure (hypertension) if nothing is done will be after the year 2020 an important public health issue for all governments; especially the Russia, China, and parts of sub-Saharan Africa. The WHO estimates that more than 8 out of 10 people in the world are victims of heart attack. This shows the seriousness of the diseases, and considers this part of the world’s population victims of cardiovascular diseases. One would have to say that, the number of victims of Cardio vascular diseases are increasing more and more and is a serious economic problem for all governments [1, 2]. That why it is very important, that telemedicine must be a priority for our government, because we can use it to reduce effectively the percentage of cardiovascular diseases, also to prevent different case and finally to ameliorate the conditions of patients. How can these new technologies, especially telemedicine help us to cure and prevent these cardio-vascular diseases?

Purpose of this work: A review of existing telemedicine solutions in cardiology.

The history of telemedicine began in the 60s in the United States; including the networking programs teleconsultation and distance education around the Nebraska Psychiatric Institute. Two other symbolic dates may also serve as reference points to the emergence of telemedicine: in 1965 the first videoconferencing in cardiac surgery between the United States and Switzerland, and in 1973 the first International Congress on Telemedicine in Michigan, which is the launch of many projects. The revival of telemedicine official date of the late 1980s in Scandinavia, especially in Norway, with the initiation of a program called "Access to Health Care Services". A more advanced technology and lower costs have led to great successes in the various telemedicine projects set place. Those projects focus on a number of applications on teleconsultation "real times" in radiology, dermatology, cardiology, psychiatry and ear, nose and throat.

Telemedicine (also referred to as "telehealth" or "e-health") allows health care professionals to evaluate, diagnose and treat patients in remote locations using telecommunications technology. Telemedicine allows patients in remote locations to access medical expertise quickly, efficiently and without travel. Telemedicine provides more efficient use of limited expert resources who can "see" patients in multiple locations wherever they are needed without leaving their facility. In developed and developing countries telemedicine offers a reduced cost solution to delivering remote care when and where it is needed without the building and staffing added facilities [1].

The main applications are: tele-consultation and tele-diagnosis: remote medical consultation; the remote monitoring or remote monitoring of a patient; tele-expertise: advice given remotely by an expert or doctor; distance education: consulting medical information (databases, imaging, training courses); the creation of telemedicine network: transmission of files; tele-surgery for manipulating medical equipment remotely and have a direct action of the practitioner on the patient.

Telemedicine applications are many and diversified but the main ones are:

1) imaging: computer tools allowed the digitization of images. Now, images from X-ray equipment are directly displayed on the screen for the radiologist, and stored in digital form. Thus, the radio medium is brought to disappear. Direct scanning of images have many advantages: an economy of film radio, space-saving, reproducibility of images, a lower risk of loss of clichés, a transmission shadow copies to all stakeholders in the management of the patient , facilitation of discussion and exchanges around the same distance and image of the same patient. The risk of misinterpretation is the same as a standard cliché. The support can be put in because as long as the radiologist is trained in these new technologies [2];

2) the remote diagnosis and assistance in the diagnosis is mainly based on the transfer of data from the clinical examination and / or data from additional tests or imaging laboratory. All these data can be transmitted in real time or delayed. The diagnosis can be synchronous or not, that is to say, or not performed live, with simultaneous connection or not stakeholders. This type of remote consultation to transpose in different disciplines such as cardiology, obstetrics and pediatric emergency;

3) the “telecare” means establishing a relationship between a specialist acting as a mentor and a primary care physician, a resident, caregiver or nurse. Such services relate to the surrounding structures and allows interns and doctors in training to keep in touch with the hospitals;

4) the remote staffs are held in the form of video conferences that provide a collaborative relationship between health professionals, based on the sharing of expertise. Current applications are common in the discussion of medical records, the initiation of treatment protocols, coordinated care of patients within protocols in different specialties such as oncology, cardiology, etc.;

5) tele-monitoring is the practice at home or in a primary care medical surveillance at a distance. Telecare and / or remote monitoring introduced the concept of medical aid provided to a single person (not doctor) or by controlling or guiding the actions of a remote operator or by monitoring clinical parameters (electrocardiogram, blood sugar, etc. .) or by controlling a robot. The teleprocessing allows monitoring and treatment adjustment, ongoing evaluation of the disease. This practice involves specialized structures for mass pathologies such as diabetes, monitoring and treatment adjustment of heart rhythm disorders, follow myocardial infarction and cardiovascular surgery;

6) tele-surgery involves the surgical procedure assistance, including preparation of the operation by simulations in three-dimensional imaging and remote handling. Telesurgery provides the ability to operate remotely and has two aspects: the remote surgical assistance of an expert physician and surgery remote computer or robot. Both types of surgery require television transmission, real-time images of a patient.

In cardiology, the Level 1 priorities are remote diagnostics and tele-expertise by video multidisciplinary staff and between teleconsultation and a cardiology referral center (cases presenting with ECG, ultrasound static and dynamic images of coronary angiography). Moreover, interventional cardiology, a single experiment by a telecare referral center for coronary angiography and angioplasty performed in another [3].

The world is currently undergoing a major technological revolution in all areas, especially in the field of medicine. Thanks to new Technologies such as telehealth; it is now possible to conduct consultations and treatments for patients remotely, and even perform remote operations due to telemedicine, also, the establishment of a medical record computerized setting for many years of personal health data, the possibility for any patient to inform himself about his disease in the humanity library posed by the internet, the possibility for doctors and staff Paramedics to match them remotely.These possibilities are opened to today patients to benefit from quality care at home, safely, without having to travel.

The digital system is now an integral part of the health organization’s systems. It brings a better quality of care in patients growing older with chronic diseases. It improves the diagnostic performance, medical and security processing. It allows any citizen regardless of where they live benefit from the current data in medical science. Even if these technologies require many ways for example financial and skilled manpower, the Ukrainian government has a bearing procedure for the decentralization of field with the multiplication of centers of analysis of data remotely, clinics and hospitals and henceforth it is possible to realize cardiac operations at a distance.

Literature:

1. Atoui, H. Advanced methods of data fusion of ECG and clinical data for self-care diagnosis enhancement / H. Atoui, J. Fayn, P. Rubel // 6th STAFF Studies Symposium. September 28 - October 1, 2005.

2. Bellavance, M. Implanting telehealth network for pediatric cardiology: learning from the Quebec experience / M.J. Beland, N.H. Paquet, M. Ducharme [etc.] // Cardiology in the Young. 14(6): 608-14, 2004 Dec.

3. Rubel, P. New paradigms in tele-medicine :ambient intelligence, wearable, pervasive and personalized / P.Rubel, J. Fayn, L. Simon-Chautemps [etc.] // Stud. Health Technol. Inform. – Vol. 108, - 2004. – P. 123-132.